• Marco Cascella, Alessandro Laudani, Giuliana Scarpati, and Ornella Piazza.
• Dipartimento di Medicina, Chirurgia, Odontoiatria 'Scuola Medica Salernitana', Università di Salerno.
• Curr Opin Anaesthesiol. 2024 Apr 1; 37 (2): 199204199-204.

Purpose Of ReviewIncreased public awareness of ethical issues in pain and palliative care, along with patient advocacy groups, put pressure on healthcare systems and professionals to address these concerns.Our aim is to review the ethics dilemmas concerning palliative care in ICU, artificial intelligence applications in pain therapy and palliative care, and the opioids epidemics.Recent FindingsIn this focus review, we highlighted state of the art papers that were published in the last 18 months, on ethical issues in palliative care within the ICU, artificial intelligence trajectories, and how opioids epidemics has impacted pain management practices (see Visual Abstract).SummaryPalliative care in the ICU should involve a multidisciplinary team, to mitigate patients suffering and futility. Providing spiritual support in the ICU is an important aspect of holistic patient care too.Increasingly sophisticated tools for diagnosing and treating pain, as those involving artificial intelligence, might favour disparities in access, cause informed consent problems, and surely, they need prudence and reproducibility.Pain clinicians worldwide continue to face the ethical dilemma of prescribing opioids for patients with chronic noncancer pain. Balancing the need for effective pain relief with the risk of opioid misuse, addiction, and overdose is a very controversial task.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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